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New research showing heart attack patients face a higher risk of death and slower treatment if they go to the ER after hours underscores the need for better 24/7 hospital care, a Toronto doctor says.

“The weekend effect is present, the weekend effect is consistent and it’s there even in areas where we think we are providing 24/7 care,” said Dr. Chaim Bell, an internal medicine specialist at Mount Sinai Hospital and professor at the University of Toronto medical school.

He co-authored an editorial in the British Medical Journal that accompanies a major study showing heart attack patients who arrive at hospital off hours face a 5-per-cent relative increase in mortality.

In Canada, that translates into about 600 extra deaths annually, Bell estimated.

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Cardiovascular disease accounts for 29 per cent of all deaths in Canada. Of those deaths, 23 per cent of them are caused by heart attacks.

The study also shows that off-hours patients face delays of nearly 15 minutes for emergency angioplasty, which involves widening narrowed or obstructed arteries with a balloon catheter.

“Acute myocardial infarction (heart attack) has high mortality, but early medical and surgical intervention can be life saving,” Bell wrote.

The research involved a meta-analysis of 48 studies on the issue involving almost two million patients from Canada, the United States and Europe. They included one study done by Bell that looks at treatment provided to patients in all Ontario hospitals.

The meta-analysis was conducted by the U.S. Mayo Clinic and published, along with the editorial, on Tuesday.

Bell said the findings indicate that hospitals around the world — including Ontario and Canada — must do a better job of caring for heart attack victims who come to the ER in the evening, overnight and on weekends.

“Hospital performance should be consistent around the clock,” he said.

This could involve looking at staffing levels, mix of expertise, triaging procedures and patient flow, he explained.

“Managers seeking to boost their hospital’s performance for patients with acute myocardial infarction should focus on improving their off-hour care, with the goal of providing consistently high-quality care 24 hours a day and seven days a week,” states the editorial.

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